TY - JOUR
T1 - Sagittal Spinal Deformity in Patients with Idiopathic Normal Pressure Hydrocephalus
AU - Lenartowicz, Karina A.
AU - Naylor, Ryan M.
AU - Mikula, Anthony L.
AU - Graff-Radford, Jonathan
AU - Jones, David T.
AU - Cutsforth-Gregory, Jeremy K.
AU - Graff-Radford, Neill R.
AU - Fogelson, Jeremy L.
AU - Cogswell, Petrice M.
AU - Elder, Benjamin D.
N1 - Publisher Copyright:
© 2023, Turkish Neurosurgery.All Rights Reserved.
PY - 2023
Y1 - 2023
N2 - AIM: To measure the baseline spinopelvic parameters and characterize the sagittal, and coronal plane deformities in patients with idiopathic normal pressure hydrocephalus (iNPH). MATERIAL and METHODS: We analyzed a series of patients at one academic institution who underwent ventriculoperitoneal shunting for iNPH with pre-shunt standing full length x-rays. The series of patients was enrolled consecutively to minimize selection bias. We quantified comorbid sagittal plane spinal deformity based on the Scoliosis Research Society-Schwab classification system by assessing pelvic incidence and lumbar lordosis mismatch (PI-LL), pelvic tilt (PT), and sagittal vertical axis (SVA). RESULTS: Seventeen patients (59% male) were included in this study. Mean (± standard deviation) age was 74 ± 5.3 years with a body mass index (BMI) of 30 ± 4.5 kg/m2. Six patients (35%) had marked sagittal plane spinal deformity by at least one parameter: five (29%) had greater than 20° PI-LL mismatch, three (18%) had >9.5 cm SVA, and one (6%) had PT greater than 30˚. Additionally, the thoracic kyphosis exceeded the lumbar lordosis in nine patients (53%). CONCLUSION: Positive sagittal balance, with thoracic kyphosis exceeding lumbar lordosis, is common in iNPH patients. This may lead to postural instability, especially in patients whose gait does not improve following shunting. These patients may warrant further investigation and workup, including full length standing x-rays.
AB - AIM: To measure the baseline spinopelvic parameters and characterize the sagittal, and coronal plane deformities in patients with idiopathic normal pressure hydrocephalus (iNPH). MATERIAL and METHODS: We analyzed a series of patients at one academic institution who underwent ventriculoperitoneal shunting for iNPH with pre-shunt standing full length x-rays. The series of patients was enrolled consecutively to minimize selection bias. We quantified comorbid sagittal plane spinal deformity based on the Scoliosis Research Society-Schwab classification system by assessing pelvic incidence and lumbar lordosis mismatch (PI-LL), pelvic tilt (PT), and sagittal vertical axis (SVA). RESULTS: Seventeen patients (59% male) were included in this study. Mean (± standard deviation) age was 74 ± 5.3 years with a body mass index (BMI) of 30 ± 4.5 kg/m2. Six patients (35%) had marked sagittal plane spinal deformity by at least one parameter: five (29%) had greater than 20° PI-LL mismatch, three (18%) had >9.5 cm SVA, and one (6%) had PT greater than 30˚. Additionally, the thoracic kyphosis exceeded the lumbar lordosis in nine patients (53%). CONCLUSION: Positive sagittal balance, with thoracic kyphosis exceeding lumbar lordosis, is common in iNPH patients. This may lead to postural instability, especially in patients whose gait does not improve following shunting. These patients may warrant further investigation and workup, including full length standing x-rays.
KW - Adult spinal deformity
KW - Health-related quality of life
KW - Idiopathic normal pressure hydrocephalus
KW - Postural instability
KW - Scoliosis Research Society-Schwab classification
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U2 - 10.5137/1019-5149.JTN.36555-22.3
DO - 10.5137/1019-5149.JTN.36555-22.3
M3 - Article
AN - SCOPUS:85160440924
SN - 1019-5149
VL - 33
SP - 471
EP - 476
JO - Turkish Neurosurgery
JF - Turkish Neurosurgery
IS - 3
ER -